Arthur I. Rothman

A review of the evaluation of clinical teaching: new perspectives and challenges *

This article discusses the importance of the process of evaluation of clinical teaching for the individual teacher and for the programme. Measurement principles, including validity, reliability, efficiency and feasibility, and methods to evaluate clinical teaching are reviewed.

Clinical teaching: maintaining an educational role for doctors in the new health care environment

Good clinical teaching is central to medical education but there is concern about maintaining this in contemporary, pressured health care environments. This paper aims to demonstrate that good clinical practice is at the heart of good clinical teaching.

Large-scale high-stakes testing with an OSCE: report from the Medical Council of Canada.

No abstract available.

Guidelines for Estimating the Real Cost of an Objective Structured Clinical Examination.

A major impediment to the use of the objective structured clinical examination (OSCE) is that it is a labor-intensive and costly form of assessment. The cost of an OSCE is highly dependent on the particular model used, the extent to which hidden costs are reported, and the purpose of the examination. The authors detail hypothetical costs of running a four-hour OSCE for 120 medical students at one medical school. Costs are reported for four phases of this process: development, production, administration, and post-examination reporting and analysis. Costs are reported at two ends of the spectrum: the high end, where it is assumed that little is paid for by the institution and that faculty receive honoraria for work put into the examination; and the low end, where it is assumed that the sponsoring institution defrays basic costs and that faculty do not receive honoraria for their participation. The total costs reported for a first-time examination were

Validity and generalizability of global ratings in an objective structured clinical examination.

104,400 and

An objective structured clinical examination for the licentiate of the Medical Council of Canada: from research to reality.

59,460 (Canadian dollars) at the high and low ends, respectively. These translate to per-student costs of

The ethics objective structured clinical examination

870 and

Effect of an undergraduate medical curriculum on students' self-directed learning.

496. The cost of running an OSCE is high. However, the OSCE is uniquely capable of assessing many fundamental clinical skills that are presently not being assessed in a rigorous way in most medical schools.

The Effect of Incorporating Normative Data into a Criterion-referenced Standard Setting in Medical Education

Abstract The performance of foreign medical graduates on multistation standardized patient‐based tests was used to determine the validity and generalizability of global ratings of their clinical competence made by expert examiners. Data were derived from the entrance examinations of the 1989 and 1990 applicants to the Ontario Pre‐Internship Program and the exit examination of 24 participants from the 1989 cohort. For each candidate, the examiners completed a detailed checklist and two five‐point global ratings dealing with the candidates approach to the patients problem and attitude toward the patient. Generalizability coefficients for both ratings were satisfactory and stable across cohorts. Construct validity of the global ratings was demonstrated by comparing entry and exit ratings and by evidence of significant and positive correlations between the global ratings and total test scores. Tentative evidence of criterion validity of the global ratings was demonstrated. These findings suggest that global ratings by expert examiners can be used as an effective form of assessment in multistation standardized patient examinations. Acad. Med. 66(1991):545–548.

Assessing Competency to Address Ethical Issues in Medicine.

No abstract available.